Objective: This study aimed to compare the efficacy and safety of romosozumab, a bone anabolic agent, versus vertebroplasty, a conventional surgical intervention, in treating osteoporotic vertebral compression fractures (OVCFs). Methods: A retrospective analysis included 86 thoracic/lumbar compression fracture patients from 2014 to 2022 at a medical center. Forty-two patients received romosozumab (monthly injections for 1 year) followed by 1 year of denosumab, while 44 underwent vertebroplasty followed by denosumab injections biannually for 2 years. Outcomes were assessed using the Numerical Rating Scale (NRS) for pain, bone mineral density (BMD), vertebral compression ratio, and Cobb angle over 12 months. Results: At 12 months, the romosozumab group showed a greater reduction in NRS scores (4.90 ± 1.01 vs. 4.27 ± 1.34, p = 0.015) and a higher increase in lumbar BMD (0.8 ± 0.5 vs. 0.5 ± 0.3, p = 0.000) compared to the vertebroplasty group. There were no significant differences in changes in hip total BMD and femur neck BMD (p = 0.190, p = 0.167, respectively). Radiographic assessments showed no significant differences in vertebral compression ratio (14.7% vs. 14.8%; p = 0.960) or Cobb angle (4.2° vs. 4.9°; p = 0.302). The incidence of major osteoporotic fractures was lower in the romosozumab group (7.1% vs. 25.0%, p = 0.051), with similar rates of cardiovascular events in both groups (4.8% vs. 9.1%, p = 0.716). Conclusion Romosozumab has demonstrated superior pain reduction and lumbar BMD improvement compared to vertebroplasty at 12 months, with no significant differences in radiographic outcomes or adverse events, suggesting it as an alternative to vertebroplasty for OVCF.

BACKGROUND/OBJECTIVES: Dietary factors act on lower urinary tract symptoms (LUTS).This study examined the relationship between the overall diet quality and LUTS. SUBJECTS/METHODS: This study analyzed the data from examinees who visited a general hospital in Korea (October 13, 2014−March 12, 2020). The number of subjects in the study was 6,506 adult men. The recommended food score was used to evaluate the overall quality of the diet, and the International Prostate Symptom Score was used to quantify LUTS. Logistic regression analysis was used to derive the odds ratio (OR) and 95% confidence interval (CI) to evaluate the relationship between the dietary quality and LUTS. The influence of age, education, marital history, income, occupation, smoking, drinking, exercise, metabolic syndrome, body mass index (BMI), and prostate-specific antigen (PSA) level was analyzed to determine the net influence of the overall diet quality on LUTS. RESULTS: The group with high overall dietary quality showed a lower incidence of LUTS than the group with relatively lower dietary quality (OR, 0.88; 95% CI, 0.79–0.99). These results were also observed after correcting for other risk factors and associated variables: age, education, smoking, metabolic syndrome, BMI, and PSA level. CONCLUSION The overall diet quality and LUTS were correlated. Nevertheless, further research will be needed to find the relationship between diet quality and LUTS.

Objectives: This study aimed to investigate the combined effects of individual, household, and community-level factors on coronavirus disease 2019 (COVID-19) vaccination intention using a multilevel analysis. Methods: This cross-sectional study analyzed raw data from the 2021 Korea Community Health Survey and regional statistics from 255 health centers, with a final sample of 229,216 individuals.Multilevel analysis was conducted, focusing on individual, household, and community-level factors. Individual-level factors included demographics, health status, and COVID-19 concerns;household-level factors included income and marital status; and community-level factors included city type and vaccination rates. Results: At the individual level, significant differences were observed across all variables. At the household level, higher vaccination intention was associated with households of 4 or more members and a monthly income of 4 million Korean won or more. At the community level, higher flu vaccination rates, greater concern about COVID-19 infection, and higher COVID-19 vaccination rates were linked to increased vaccination intention. Conclusion This study highlights that COVID-19 vaccination intention is influenced by factors at the individual, household, and community levels. Vaccination strategies that integrate household and community-level approaches may be more effective. Policymakers should consider both individual and social health factors when designing vaccination policies.

Objective: This study aims to understand the structure of meaning in life among patients with cancer through the validation of the Meaning in Life Scale among Korean patients (K-MiLS) with cancer. Methods: From August 2021 to November 2022, participants were recruited from multiple sites in South Korea. Participants completed related questionnaires, including the MiLS, on the web or mobile. Test-retest reliability was assessed between 2 and 4 weeks after the initial assessment. Exploratory and confirmatory factor analyses and Pearson’s correlations were used to evaluate the reliability and validity of the MiLS. A multiple regression analysis was conducted to examine the sociodemographic and disease-related variables correlated with the MiLS. Regarding concurrent validity, a hierarchical regression analysis was performed. Results: The results (n=345) indicated that the K-MiLS has a four-factor structure: Harmony and Peace; Life Perspective, Purpose, and Goals; Confusion and Lessened Meaning; and Benefits of Spirituality. Regarding convergent and discriminant validity, K-MiLS was negatively correlated with Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Fear of Cancer Recurrence Inventory while showing a significantly positive correlation with the Posttraumatic Growth Inventory, Self-Compassion Scale, Functional Assessment of Cancer Therapy-General, and Functional Social Support Questionnaire. Hierarchical regression analysis revealed that the demographic variable influencing MiLS was religious affiliation. Conclusion The K-MiLS had a multidimensional four-factor structure similar to that of the original version. It is also a reliable and valid measure for assessing cancer survivors’ meaning in life after a cancer diagnosis.

This review classifies and summarizes the major shoulder diseases affecting older adults, focusing on rotator cuff disease, frozen shoulder, osteoarthritis, and shoulder instability. It explores each condition's pathophysiology, risk factors, clinical presentation, diagnostic approaches, and treatment strategies to guide clinicians in optimizing patient outcomes and enhancing quality of life. Age-related degenerative changes, comorbidities, and distinct etiological factors contribute to the presentation of shoulder disorders in older adults. Rotator cuff disease ranges from tendinopathy to full-thickness tears and is influenced by genetic predispositions, inflammatory cytokines, and muscle quality. Frozen shoulder results from fibroproliferative changes in the capsule, leading to significant pain and restricted motion. Osteoarthritis involves cartilage degeneration and bony remodeling, often necessitating surgical interventions such as arthroplasty. Shoulder instability, though less frequent, is complicated by associated injuries like rotator cuff tears and fractures, requiring tailored management strategies. Advances in imaging techniques, biologic treatments, and surgical procedures, particularly arthroscopic and arthroplasty options, have improved diagnostic accuracy and therapeutic outcomes. A thorough classification of shoulder diseases in older adult patients highlights the complexity of managing these conditions. Effective treatment requires individualized approaches that integrate conservative measures with emerging biologic or surgical therapies. Future research should focus on targeted interventions, standardized diagnostic criteria, and multidisciplinary collaboration to minimize disability, optimize function, and improve overall quality of life in this growing patient population. Multimodal strategies, including patient education, structured rehabilitation, and psychosocial support, further enhance long-term adherence and outcomes. Ongoing vigilance for comorbidities, such as osteoporosis or metabolic disorders, is necessary for comprehensive care.

Purpose: To evaluate the long-term efficacy, safety, and prognostic factors of pulsed-light accelerated corneal collagen cross-linking (A-CXL) with continuous riboflavin application to halt keratoconus progression Methods: A-CXL with retention ring-assisted continuous riboflavin application for either 10 or 5 minutes was performed in 37 eyes of 33 patients with progressive keratoconus between 2016 and 2020. Successful halting rates and prognostic factors of time-dependent changes in keratometric values, visual acuity, refractive errors, topographic indices, central corneal thickness, thinnest corneal thickness, irregularity at 3- and 5-mm zone, and endothelial cell density were evaluated. Results: Survival analysis showed successful halting rates of 71% and 89% in A-CXL with 5- and 10-minute–applied riboflavin, respectively. Best-corrected visual acuity significantly improved after A-CXL in both groups. Maximum keratometry decreased significantly from 52.52 to 50.39 diopters (p < 0.001) in the 10-minute group, while there was no significant decrease in the 5-minute group (52.77–51.80 diopters, p = 0.146). irregularity in 3- and 5-mm zone decreased significantly in the 10-minute group, while there was no difference in 5-minute group. Central corneal thickness and thinnest corneal thickness did not differ, and endothelial cell density changes were within acceptable ranges in both groups before and after the surgery. Among keratometric values, keratometric astigmatism was significantly related to posttreatment corneal flattening effect in multivariate regression analysis. Conclusions A-CXL with continuous riboflavin application for 10 minutes is an effective and safe treatment for preventing keratoconus progression. In addition, higher corneal astigmatism showed greater posttreatment corneal flattening effect in successfully treated patients.

Purpose: To investigate ocular manifestation of immune reconstitution inflammatory syndrome (IRIS) in HIV patients after starting highly active antiretroviral therapy (HAART) and its relationship to T cell immunity. Methods: HIV patients with ocular IRIS after HAART were retrospectively reviewed. Clinical presentations with previous opportunistic infection, duration from initiation of HAART to IRIS, blood CD4+, CD8+ T cell count, and HIV RNA copies before HAART and at IRIS were analyzed. Results: Among 19 patients (27 eyes) included, the most common previous opportunistic infection was cytomegalovirus (17 patients, 89.5%) followed by tuberculosis choroiditis (2 patients, 10.5%). The clinical manifestations included vitritis (20 eyes, 74.0%), retinitis (14 eyes, 51.9%), and anterior uveitis (5 eyes, 18.5%). The median duration from initiation of HAART to IRIS was 70 days. CD4+ T cell count before HAART increased at IRIS (p < 0.001). CD8+ T cell count before HAART was negatively correlated with duration from HAART to IRIS (p < 0.001). The cutoff value of CD8+ T cell count for discerning early or late onset of ocular IRIS was 258/mm3 (p = 0.001). When divided into two groups by CD8+ T cell count of 258/mm3, 90% patients with CD8+ T cell count higher than 258/mm3 before HAART developed ocular IRIS within 70 days. Conclusions There was a negative relationship between CD8+ T cell count before HAART and duration from HAART to ocular IRIS. Ocular IRIS with higher CD8+ T cell count before HAART developed earlier after HAART initiation compared to those with lower CD8+ T cell count.

Purpose: To investigate the outcomes of brolucizumab reinjection after intraocular inflammation (IOI) development. Methods: This retrospective study analyzed patients with brolucizumab injections from April 2021 to January 2024. Patients who developed IOI after brolucizumab were included and categorized into subgroups depending on reinjection, discontinuation, and further IOI development. Results: A total of 472 eyes of 432 patients received brolucizumab injections. Thirty-eight cases developed IOI at least once, and 25 continued brolucizumab. Sixteen cases had no more IOI events, and nine experienced a second or more IOI events. Among the nine cases, three maintained brolucizumab injections despite IOI recurrence. The incidence of IOI was 8.1% based on the number of eyes (38 of 472 eyes) and 2.0% based on the number of brolucizumab injections (50 of 2,468 injections). The incidence of occlusive retinal vasculitis was 0.2% (1 of 472 eyes). The recurrence rate was 23.7% (9 of 38 eyes). The average number of injections between the first brolucizumab injection and the injection date on which IOI first developed was 2.15 times in the no-reinjection group, 3.44 times in the no-IOI-recurrence group, and 2.0 times in the second-IOI-episode group. Time to IOI occurrence in cases with first IOI episode was 18.60 ± 16.73 days, with 15 cases developing IOI within 1 week. Conclusions This study elucidates the real-world incidence of brolucizumab associated IOIs, with a description of information related to reinjections after the IOI episodes. A comprehensive understanding of brolucizumab reinjection is essential for its optimal utilization.

Ectopic thyroid is thyroid tissue found in places other than the anterolateral aspect of the second to fourth tracheal ring. Mediastinal ectopic thyroid is rare and only few cases have been reported. The authors experienced a case of 41-year-old female patient with an anterior neck mass. The patient had mild chest discomfort when breathing with no other symptoms. Imaging studies suggested tumor of thymic tissue origin and surgical excision was done. The mass was successfully removed and histopathologically determined to be thyroid tissue. We hereby report with a review of literature a case of ectopic thyroid found in the mediastinum, which was successfully removed by transcervical incision.